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Sunday, 17 April 2011
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Long in the Tooth
Ever heard the expression "Long in the Tooth"? It usually refers to someone older or wiser. Interestingly, this old expression is based in reality.
As you may have read in earlier posts, gum disease (aka periodontal disease) results in bone loss around teeth. Bone loss around teeth also occurs as a natural consequence of aging, albeit at a much slower rate than is seen in gum disease. When the bone and gum around teeth recede, or draw back, the teeth appear longer, as more tooth is exposed in the mouth.
Prior to the 1950's, most North Americans didn't brush their teeth. The high standards of dental hygiene, dental care, and home dental care that we enjoy today were not the norm for most of human history. As such, bone loss used to be very common as people aged, giving rise to the association between "long teeth" and advanced age.
As you may have read in earlier posts, gum disease (aka periodontal disease) results in bone loss around teeth. Bone loss around teeth also occurs as a natural consequence of aging, albeit at a much slower rate than is seen in gum disease. When the bone and gum around teeth recede, or draw back, the teeth appear longer, as more tooth is exposed in the mouth.
Prior to the 1950's, most North Americans didn't brush their teeth. The high standards of dental hygiene, dental care, and home dental care that we enjoy today were not the norm for most of human history. As such, bone loss used to be very common as people aged, giving rise to the association between "long teeth" and advanced age.
Saturday, 9 April 2011
The Foundation
Last time we covered the teeth themselves....this time I'll go into how teeth are anchored in place...and just how unique that anchorage is.
As I mentioned last time, teeth are the only organs in our body that are anchored in bone AND are exposed to the outside environment. You can imagine this is pretty tricky to make work...and it is! Our bodies are excellent at keeping bacteria and foreign matter out, while keeping the inside perfectly clean. To have a part of our body that breaches the "Seal" of skin or mucous membrane is unique.
Your teeth are anchored in the bone of your upper or lower jaw via a tiny network of millions of short ligaments, collectively known as the periodontal ligament. These little ligaments, while only a fraction of a millimeter long, are associated with equally tiny nerves that sense any stretching of the ligament. Thus, an intact periodontal ligament allows us to have proprioception, or sensation of position. Imagine trying to chew an almond with no sense of how hard you were biting!
As we move toward the "crown" of the tooth, or the part that sticks out in your mouth, we see a different type of fibers become predominant. These collagen fibers (13 different types) are woven in a complex web that interconnect tooth to tooth, gum to tooth and gum to bone like a very busy, tangled, taut set of guywires. Imagine burying a few broomsticks in a row in the dirt and wrapping yarn every which way around them....you get the idea! These "dentogingival" fibers are incredibly important, as they reinforce the attachment of your gums to your teeth and supporting bone. Without these fibers, your gums would get pushed around by food and hang loosely around your teeth like worn-out turtleneck sweaters. Instead, healthy gums hug the teeth and bone, shedding food and thus avoiding trauma and bacterial invasion.
Why is this Important?
OK, here's where the rubber hits the road. You've heard of gum disease, also known as pyorrhea or periodontal disease. In this disease, bacteria live between the gum and tooth and induce your body to initiate an immune response. Your body wants those bugs out of there! Problem is, in the process of attempting to destroy the bacteria, the collagen fibers discussed above, as well as the anchoring bone, also get destroyed. These slow, painless changes lead to boggy, red, limp gums that aren't tough insulators and seal poorly. Additionally, the bone loss that occurs makes the teeth looser and looser...until they are lost. More on that later.
Did you know?
The root surfaces of teeth, normally covered by gum and / or bone, have nine times the nerve density of the crown of the tooth (the top that sticks out). If the root surfaces are exposed due to loss of collagen fibers, the gums don't hug the teeth as tightly, and thus the root surfaces are exposed to whatever you put into your mouth...leading to sensitive teeth!
As I mentioned last time, teeth are the only organs in our body that are anchored in bone AND are exposed to the outside environment. You can imagine this is pretty tricky to make work...and it is! Our bodies are excellent at keeping bacteria and foreign matter out, while keeping the inside perfectly clean. To have a part of our body that breaches the "Seal" of skin or mucous membrane is unique.
Your teeth are anchored in the bone of your upper or lower jaw via a tiny network of millions of short ligaments, collectively known as the periodontal ligament. These little ligaments, while only a fraction of a millimeter long, are associated with equally tiny nerves that sense any stretching of the ligament. Thus, an intact periodontal ligament allows us to have proprioception, or sensation of position. Imagine trying to chew an almond with no sense of how hard you were biting!
As we move toward the "crown" of the tooth, or the part that sticks out in your mouth, we see a different type of fibers become predominant. These collagen fibers (13 different types) are woven in a complex web that interconnect tooth to tooth, gum to tooth and gum to bone like a very busy, tangled, taut set of guywires. Imagine burying a few broomsticks in a row in the dirt and wrapping yarn every which way around them....you get the idea! These "dentogingival" fibers are incredibly important, as they reinforce the attachment of your gums to your teeth and supporting bone. Without these fibers, your gums would get pushed around by food and hang loosely around your teeth like worn-out turtleneck sweaters. Instead, healthy gums hug the teeth and bone, shedding food and thus avoiding trauma and bacterial invasion.
Why is this Important?
OK, here's where the rubber hits the road. You've heard of gum disease, also known as pyorrhea or periodontal disease. In this disease, bacteria live between the gum and tooth and induce your body to initiate an immune response. Your body wants those bugs out of there! Problem is, in the process of attempting to destroy the bacteria, the collagen fibers discussed above, as well as the anchoring bone, also get destroyed. These slow, painless changes lead to boggy, red, limp gums that aren't tough insulators and seal poorly. Additionally, the bone loss that occurs makes the teeth looser and looser...until they are lost. More on that later.
Did you know?
The root surfaces of teeth, normally covered by gum and / or bone, have nine times the nerve density of the crown of the tooth (the top that sticks out). If the root surfaces are exposed due to loss of collagen fibers, the gums don't hug the teeth as tightly, and thus the root surfaces are exposed to whatever you put into your mouth...leading to sensitive teeth!
Saturday, 2 April 2011
The big Picture
Let's start by having a big-picture look at the mouth, starting with your teeth themselves.
Most people don't spend much time thinking about their teeth, chewing, swallowing, or speaking. However, your teeth play a critical role in all those functions, and are highly specialized to do so. Notice how your lower lip intersects perfectly with your upper front teeth to make the "F" sound, or how your upper and lower front teeth almost touch to make an "S" sound. Further, our mouth represents the very beginning of our digestive tract, and has the important role of beginning the process of digestion by breaking food down into more easily digestible bits. As such, your teeth can be thought of as units in a grinding apparatus. When your teeth are healthy and solidly anchored, they are capable of creating incredible forces to break up hard foods. Adults can generally create about 250 pounds per square inch of force between their back teeth, with some Northern Inuit populations able to create up to 500 PSI due to their very chewy diet of seal and whale meat!
Did you know?
The ability to chew hard foods is critical to the health of the rest of your body. Whole grains, nuts, meat, fibrous vegetables like celery, and other whole foods generally require a healthy chewing system to be ingested efficiently. Because critical menu items like dietary fiber and nutrient-dense foods are typically harder to chew, people who can't chew well due to dental disease or tooth loss often show lower blood levels of important vitamins and minerals. One interesting scientific study looked at blood nutrient levels in patients before and after they had their teeth extracted and complete dentures made. It was discovered that the patient's ability to exert chewing pressure on the food dropped to 20% of its prior (real teeth) level, and the blood levels of key nutrients dropped over the following months due to dietary changes as patients began to avoid harder-to-chew (nutrient rich) whole foods.
Teeth are the hardest tissue in the entire body, and are composed of a few different components. The enamel, or hardest part, is the bright white layer that covers most or all of the part of the tooth that you can see in your mouth. The dentin forms the core of the tooth, and most of its bulk. While it's less mineralized (and thus softer) than enamel, dentin's relative porosity creates space for tiny nerve endings to extend throughout the tooth, giving it sensation. These nerve endings originate in the center of the tooth, where a soft tissue mass known as the "pulp" resides, running up the center much like the lead in the center of a pencil. The nerves and blood vessels in the pulp provide the ability for individual teeth to have sensation to temperature, sweet, spicy, and pressure. This sensation is protective insofar as it serves to warn us when we bite into or chew something potentially harmful, like ice or a pebble in our food.
Fast Fact: The mouth is the only place in the body where a rigid structure breaches the skin or mucous membrane. Teeth, anchored in bony sockets, emerge through the gums during growth. The fact that the gums are not pushed away by eating is due to an anatomical "wonder of the world" known as the periodontal attachment (more on that later).
Most people don't spend much time thinking about their teeth, chewing, swallowing, or speaking. However, your teeth play a critical role in all those functions, and are highly specialized to do so. Notice how your lower lip intersects perfectly with your upper front teeth to make the "F" sound, or how your upper and lower front teeth almost touch to make an "S" sound. Further, our mouth represents the very beginning of our digestive tract, and has the important role of beginning the process of digestion by breaking food down into more easily digestible bits. As such, your teeth can be thought of as units in a grinding apparatus. When your teeth are healthy and solidly anchored, they are capable of creating incredible forces to break up hard foods. Adults can generally create about 250 pounds per square inch of force between their back teeth, with some Northern Inuit populations able to create up to 500 PSI due to their very chewy diet of seal and whale meat!
Did you know?
The ability to chew hard foods is critical to the health of the rest of your body. Whole grains, nuts, meat, fibrous vegetables like celery, and other whole foods generally require a healthy chewing system to be ingested efficiently. Because critical menu items like dietary fiber and nutrient-dense foods are typically harder to chew, people who can't chew well due to dental disease or tooth loss often show lower blood levels of important vitamins and minerals. One interesting scientific study looked at blood nutrient levels in patients before and after they had their teeth extracted and complete dentures made. It was discovered that the patient's ability to exert chewing pressure on the food dropped to 20% of its prior (real teeth) level, and the blood levels of key nutrients dropped over the following months due to dietary changes as patients began to avoid harder-to-chew (nutrient rich) whole foods.
Teeth are the hardest tissue in the entire body, and are composed of a few different components. The enamel, or hardest part, is the bright white layer that covers most or all of the part of the tooth that you can see in your mouth. The dentin forms the core of the tooth, and most of its bulk. While it's less mineralized (and thus softer) than enamel, dentin's relative porosity creates space for tiny nerve endings to extend throughout the tooth, giving it sensation. These nerve endings originate in the center of the tooth, where a soft tissue mass known as the "pulp" resides, running up the center much like the lead in the center of a pencil. The nerves and blood vessels in the pulp provide the ability for individual teeth to have sensation to temperature, sweet, spicy, and pressure. This sensation is protective insofar as it serves to warn us when we bite into or chew something potentially harmful, like ice or a pebble in our food.
Fast Fact: The mouth is the only place in the body where a rigid structure breaches the skin or mucous membrane. Teeth, anchored in bony sockets, emerge through the gums during growth. The fact that the gums are not pushed away by eating is due to an anatomical "wonder of the world" known as the periodontal attachment (more on that later).
Welcome to Tooth Talk!
Thanks for visiting!
As a general practice dentist, I've noticed how great an effect education can have on the health of my patients. It's for this reason that I've decided to create this blog, whose focus will be to provide you with quality information to increase your understanding of all things dental. In the following months I'll be taking readers through a variety of topics, a sort of "Dentistry 101" course. I've been inspired by some fantastic questions that many of my patients have asked, and I hope to share some of those questions and answers with you over time.
As I intend this to be an interactive blog, I welcome your feedback, comments, and questions. Use the comment tool in blogger or e-mail me if you'd like to hear more about a certain topic. You'll also find more information specific to my practice at my website www.thevernondentist.com.
Thanks again for dropping by and see you again soon!
As a general practice dentist, I've noticed how great an effect education can have on the health of my patients. It's for this reason that I've decided to create this blog, whose focus will be to provide you with quality information to increase your understanding of all things dental. In the following months I'll be taking readers through a variety of topics, a sort of "Dentistry 101" course. I've been inspired by some fantastic questions that many of my patients have asked, and I hope to share some of those questions and answers with you over time.
As I intend this to be an interactive blog, I welcome your feedback, comments, and questions. Use the comment tool in blogger or e-mail me if you'd like to hear more about a certain topic. You'll also find more information specific to my practice at my website www.thevernondentist.com.
Thanks again for dropping by and see you again soon!
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